Spinal cord compression (non-traumatic): Difference between revisions
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#Consult neurosurgery and/or rad onc | #Consult neurosurgery and/or rad onc | ||
#Corticosteroid therapy | #Corticosteroid therapy | ||
## | ##No longer indicated. | ||
##Consider emergent radiation, surgical intervention, and/or chemo therapy | ##Consider emergent radiation, surgical intervention, and/or chemo therapy | ||
<blockquote>Administration of methylprednisolone (MP) for the treatment of acute spinal cord injury (SCI) is not recommended. Clinicians considering MP therapy should bear in mind that the drug is not Food and Drug Administration (FDA) approved for this application. There is no Class I or Class II medical evidence supporting the clinical benefit of MP in the treatment of acute SCI. Scattered reports of Class III evidence claim inconsistent effects likely related to random chance or selection bias. However, Class I, II, and III evidence exists that high-dose steroids are associated with harmful side effects including death. </blockquote> -Pharmacological therapy for acute spinal cord injury. <ref>Hurlbert RJ et al. Pharmacological therapy for acute spinal cord injury. Neurosurgery. 2013 Mar;72 Suppl 2:93-105 http://www.ncbi.nlm.nih.gov/pubmed/23417182<ref> | |||
==Disposition== | ==Disposition== | ||
Revision as of 01:46, 30 December 2013
Background
- Most often from cancer
Diagnosis
- MRI is study of choice
- If unavailable consider CT myelography
Treatment
- Consult neurosurgery and/or rad onc
- Corticosteroid therapy
- No longer indicated.
- Consider emergent radiation, surgical intervention, and/or chemo therapy
Administration of methylprednisolone (MP) for the treatment of acute spinal cord injury (SCI) is not recommended. Clinicians considering MP therapy should bear in mind that the drug is not Food and Drug Administration (FDA) approved for this application. There is no Class I or Class II medical evidence supporting the clinical benefit of MP in the treatment of acute SCI. Scattered reports of Class III evidence claim inconsistent effects likely related to random chance or selection bias. However, Class I, II, and III evidence exists that high-dose steroids are associated with harmful side effects including death.
-Pharmacological therapy for acute spinal cord injury. <ref>Hurlbert RJ et al. Pharmacological therapy for acute spinal cord injury. Neurosurgery. 2013 Mar;72 Suppl 2:93-105 http://www.ncbi.nlm.nih.gov/pubmed/23417182<ref>
Disposition
- Admit
See Also
Source
DONALDSON 9/07 (Adapted from Lampe, Hockberger, Brower, and Mistry)